Extracellular ATP Induces Vascular Inflammation and Atherosclerosis via Purinergic Receptor Y2 in Mice

Objective A solid body of evidence supports a role of extracellular ATP and its P2 receptors in innate and adaptive immunity. It promotes inflammation as a danger signal in various chronic inflammatory diseases. Thus, we hypothesize contribution of extracellular ATP and its receptor P2Y(2) in vascular inflammation and atherosclerosis. Approach and Results Extracellular ATP induced leukocyte rolling, adhesion, and migration in vivo as assessed by intravital microscopy and in sterile peritonitis. To test the role of extracellular ATP in atherosclerosis, ATP or saline as control was injected intraperitoneally 3x a week in low-density lipoprotein receptor(-/-) mice consuming high cholesterol diet. Atherosclerosis significantly increased after 16 weeks in ATP-treated mice (n=13; control group, 0.26 mm2; ATP group, 0.33 mm2; P=0.01). To gain into the role of ATP-receptor P2Y(2) in ATP-induced leukocyte recruitment, ATP was administered systemically in P2Y(2)-deficient or P2Y(2)-competent mice. In P2Y(2)-deficient mice, the ATP-induced leukocyte adhesion was significantly reduced as assessed by intravital microscopy. P2Y(2) expression in atherosclerosis was measured by real-time polymerase chain reaction and immunohistochemistry and demonstrates an increased expression mainly caused by influx of P2Y(2)-expressing macrophages. To investigate the functional role of P2Y(2) in atherogenesis, P2Y(2)-deficient low-density lipoprotein receptor(-/-) mice consumed high cholesterol diet. After 16 weeks, P2Y(2)-deficient mice showed significantly reduced atherosclerotic lesions with decreased macrophages compared with P2Y(2)-competent mice (n=11; aortic arch: control group, 0.25 mm(2); P2Y(2)-deficient, 0.14 mm2; P=0.04). Mechanistically, atherosclerotic lesions from P2Y(2)-deficient mice expressed less vascular cell adhesion molecule-1 and intercellular adhesion molecule-1 RNA. Conclusions We show that extracellular ATP induces vascular inflammation and atherosclerosis via activation of P2Y(2).